Addressing key determinants of noncommunicable diseases using an intersectoral approach: The Swaziland experience

Noncommunicable diseases (NCDs) have traditionally been associated with affluent of

lifestyles in developed nations. However, at the dawn of the new millennium, NCDs now

pose a huge health challenge in Africa, and Swaziland is no exception. It calls for urgent

action from both the Government of Swaziland and non-state actors to address the risk

factors for NCDs and their determinants. While Swaziland finds itself facing an increase

in NCDs, maternal and child morbidity and mortality, HIV and AIDS, TB and malaria also

remain a huge public health concern.

A social determinant of health approach reveals that the health outcomes of individuals,

families and communities are influenced by the social and economic conditions in which

people are born, grow, live, work and age, and the systems put in place to deal with illness,

disability and premature death. This case study was conducted to identify how actions of

various sectors could be harnessed to address key determinants of noncommunicable

diseases including their risk factors.

A secondary analysis of government policy papers, strategic plans and WHO guidelines

was conducted in addition to key informant interviews. The study examined the presence

of intersectoral actions across progragrammes and sectors namely, health in all policies,

good governance for health, leadership and stewardship roles, adequate financing,

health literacy and community empowerment. The key findings are that there is an

unnoticed, unrecorded and unabated increase of noncommunicable conditions mainly

diabetes mellitus, cardiovascular disease, hypertension, respiratory problems and HIVrelated

cancers like Kaposi’s sarcoma. The associated major risk factors are alcohol and

tobacco consumption, physical inactivity and unhealthy diet. It is concluded that a rise in

noncommunicable conditions in Swaziland requires an intersectoral approach to ensure

effective and sustainable prevention and control.